DAVID ALLEN HIRSTIUS DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125044562

License Status

CANCELLED

Business

First Name

DAVID

Middle

ALLEN

Last Name

HIRSTIUS

Suffix

Business Name

DAVID ALLEN HIRSTIUS DO

Original Issue Date

07/01/2002

Effective Date

07/01/2002

Expiration Date

06/30/2005

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006